A tad sick is an understatement. In the last post I was quite optimistic about getting back into good health and on the bicycle again, but we are both still ill and weak. I have been sick now for more than two weeks, and Cyril has been under the weather since the last two days. Luckily today we got a sound diagnosis, a bag full of medication, and it looks like we should be recovering fast.
We are currently in Khorog, the capital of the Gorno-Badakshan region. After a few days of being pretty miserable and not getting any better in Qalaikhum we took a 6 hour taxi ride to Khorog. We were hoping we would meet some of our cycling friends again at the Pamir Lodge and have a better hospital at our disposal. Both of it worked out: we saw our Dushanbe cycling buddies again and we also met up with Gerrit, whose blog we read before we left. As always it’s great to meet someone who has been an online inspiration on the road.
Tajikistan is not only famous amongst cyclists for the Pamirs, but also for it’s travelers diarrhea. So when we got it as soon as we landed in Dushanbe we shrugged our shoulders and got on with things, thinking ‘bad food’ and that it would pass. Until it didn’t. The hospital in Qalaikhun never ran any tests but nevertheless prescribed me antibiotics with severe side effects such as sun allergy and tearing tendons. Not great for a cyclist! I didn’t take them but soldiered on with probiotic pills, oral rehydration salts (ORS) and zinc supplements, hoping I could fight off whatever it was that caused it. I’ve been too weak to ride (or do anything but sleep or hang around really). There have been some days with fever and pains but mostly it’s not even been all that uncomfortable, just really annoying.
So yesterday we went to the hospital of Khorog, and finally we had a stool test done, with immediate result: we are both hosting parasites. Amoebae and Ascariasis to be precise. It was quite a shock to get this disgusting diagnosis. Tip no. 1: don’t EVER google image search your parasites, it cannot be unseen. Apart from being disgusted we are at the same time greatly relieved to have found the cause and the treatment. Two weeks of guessing and trial-and-error treatment was getting me down a bit and now we can look forward to feeling good again. Anti-parasite and antibiotics should be able to kill our horrible hitch-hikers within a day or two. Turns out the Qalaikhun hospital diagnosis of a bacterial infection was all wrong and I’m glad I didn’t take their prescribed meds.
Tips for travelers
What we will do differently next time: firstly, we will definitely keep taking all the usual precautions to stay healthy. Clean all the water we drink with our Steripen (or a similarly low-hassle water cleaning method), even though many people claim you can drink straight from the streams and sources. You never know if animals have been using the same water. Peel fruit. Avoid meat, watermelon, soft ice, and salads. Cook our own meals as much as possible. Wash our hands with water and soap (not easy to find in Tajik toilets). Secondly, should we ever feel ill again, get tested right away. It’s simple, cheap, and it avoids so many days wasted because you don’t have any energy. In these kind of countries it’s best to assume the worst. Thirdly, ask our GP to prescribe anti-parasite drugs for giardia, amoebae and worms to bring along on the trip. We brought antibiotics for bacterial gut infections but not for parasites and judging by the stories of all the cyclists we’ve met here it’s very common. Most cyclists get parasites at some point. And finally, use some easy to find local natural remedies for prevention and treatment. Eat raw crushed garlic cloves three times a day for anti-parasitic and antibacterial properties, eat kefir for probiotic strengthening of the gut and immune system. Luckily we like both but we’re going to be stinking to high heavens for the next few weeks.
We noticed some modest but exceptionally neat and tidy doctors posts in regional villages. Instead of bearing yet another huge banner with a badly photoshopped picture of president Rahmon they bear an inconspicuous plaque of the Aga Khan foundation. Our doctor yesterday also directed us to the local Aga Khan founded pharmacy. I read up a little bit about what the Aga Khan foundation is and does and it really is quite remarkable. As I wrote before, the Pamiri people are culturally different from the Tajik people. They are shi’ite as compared to the sunni majority of the country. Their branch of shia islam is called Ismailism, and the Aga Khan is their spiritual leader. Apart from this he is also a major philantropist, donating 600 million dollars every year to the worldwide Ismailite society, focusing on health, education, business development and womens rights. The benefits of these programs definitely show in the Pamirs: more people speak English, less women wear headscarves, there are some good health facilities. The Aga Khan was born in Switzerland, currently lives in France, and comes from an old world glamourous noble Iranian family. His father was briefly married to Rita Hayworth and missed out on becoming Aga Khan because his own father thought him too much of a playboy and passed on the title (and responsibilities) to his grandson instead. We think he practices great vision and leadership, and his good work will be a positive and lasting legacy.
All our well-wishers, friends, family and followers, who sent us sweet messages in the last couple of weeks. Thank you all, we are so grateful for your love and support.